Official Application Form for FULL MEMBERSHIP

APPLICATION FOR ETSI MEMBERSHIP French translation of pages 1&2 is available for information only as Annex B

Legally established, registered name and address of the applicant Administration / Organization

TEL FAX WWW

Legally established in a country within the CEPT* geographical area (Full Membership) Legally established in a country outside the CEPT* geographical area (Associate Membership) Eligible for Full or Associate Membership but requiring no participation in technical work (Observer Membership)

* CEPT - European Conference of Postal and Telecommunications Administrations operating in the following activity represented by First name, last name, position held within applicant Administration / Organization cognizant of the ETSI Statutes and Rules of Procedure available at http://portal.etsi.org/Directives/home.asp hereby applies for ETSI Membership in the category of

Administration also qualifying as SME Other Government Body (if applicable) Micro-Enterprise Consultancy Company/Partnership Trade Association Manufacturer User Association Network Operator Not-for-profit User Association Research Body (private) Research Body (public) Evidence of the above to be provided University via official reports or certifying letter Service Provider User Other and also applies to participate in 3GPP™ Yes No See Annex A – 6 (attached)

Information related to contacts

Name and address of Official Contact - the person to whom all correspondence should be sent

TEL FAX EMAIL

Page | 1 – V1.2 APPLICATION FOR ETSI MEMBERSHIP French translation of pages 1&2 is available for information only as Annex B

Name and address of Financial Contact - the person to whom all membership fee related issues should be sent (if not the same as Official Contact)

TEL FAX EMAIL Membership fee billing address (to be shown on Invoices) Invoices to be sent to the Official Contact Financial Contact Billing address European Union VAT N° SIRENE N° (for French organizations only)

Information related to the membership fee Administrations If another Administration in your country is already an ETSI Member and pays membership fees according to the Gross Domestic Product (GDP) of your country, please tick this box If your Administration is responsible for the regulation of electronics communications and related areas in that country, please indicate your country’s GDP in EUROS € See Annex A - 1 & 2 (attached)

Other Organizations Please indicate your organization’s annual Electronics Communications Related Turnover (ECRT) in EUROS (Administrations, public research bodies, universities, User/Trade Associations, not-for-profit user associations excluded) € See Annex A - 5 (attached)

Additional Membership If you are applying for an Additional Membership to an existing Group Membership for which the membership fees have already been determined - See Annex A - 4 (attached), please provide the NAME OF THE ORGANIZATION holding the relevant Group Membership ======The applicant Administration / Organization hereby agrees and commits itself to comply with the provisions of the Statutes and Rules of Procedure of ETSI and all decisions taken by the ETSI General Assembly, to contribute to the work, to make use of the standards produced to the extent practicable and to support those standards for use as the basis for world standards and recommendations. By signing this application form, you represent that you have the legal authority to bind the applicant Administration/Organization to the representations and commitments provided in this application form. Read and approved on behalf of the Administration / Organization: Name and Title of authorized person

Place Date

Membership of ETSI will be tacitly renewed unless it is withdrawn by the member organization (see Rules of Procedure, Article 1, clause 1.4.1 for full details).

Official Stamp Signature

Page | 2 – V1.2 ANNEX A

1 My Organization is an Administration Public Administration responsible for the regulation of electronics communications and related areas in a country

Administration: Defined as the part of the public administration responsible for the regulation of electronics communications and related areas in a country.

For an Administration, the class of contribution is determined according to the latest published or available figure of the Gross Domestic Product (GDP) of its country (please see Annex 2 of the ETSI Rules of Procedure). The class of contribution for Associate member Administrations may be adjusted by the Director-General taking into account any particular circumstances.

2 Another Administration in my country contributes according to the GDP of the country

When a country has more than one Administration member, one of those members shall contribute according to the scale set out in § 2 above and the other Additional Membership(s) shall contribute 1 unit.

3 My organization is an Small and Medium Enterprise (SME) / Micro-Enterprise (ME)

- less than 250 employees (SME) / less than 10 employees (ME) - annual turnover not exceeding EUR 50 million or balance sheet not exceeding EUR 43 million (SME) / annual turnover or balance sheet not exceeding EUR 2 million (ME) - an ‘autonomous’ enterprise, or limits are met when including partner or linked enterprises as per SME definition (below)

Full definition at: http://ec.europa.eu/enterprise/enterprise_policy/sme_definition/sme_user_guide.pdf

According to Clause 6 in Annex 2 of the ETSI Rules of Procedure, SME members shall, after presenting evidence to the Director-General, contribute 1 unit. Micro-Enterprises shall contribute 1 reduced unit.

4 Additional membership to a Group membership for which the class of contribution has been determined using the group’s global accounts

Companies with more than one membership from the same corporate group may either: a) Declare multiple memberships excluding the ECRT relating to transactions between companies of the same group (sometimes known as intra-company trading) when determining the class of contribution. The sum of Class of Contributions and ECRTs, respectively, for the multiple memberships shall always be equal to or greater than the Class of Contribution and ECRT for a membership determined using the worldwide turnover generated by the entire corporate group’s products and services related to Article 2 "Purpose" and Article 3 "Scope of activities" in the ETSI Statutes. OR b) Declare a multiple membership consisting of a "Group" membership, with its ECRT determined using the worldwide turnover generated by the entire corporate group’s products and services related to Article 2 "Purpose" and Article 3 "Scope of activities" in the ETSI Statutes, and one or more "Additional" membership(s) which shall contribute 1 unit each.

5 ECRT

The member's Electronics Communications Related Turn Over (ECRT) is defined as the worldwide turnover generated by all the member's products and services related to Article 2 "Purpose" and Article 3 "Scope of activities" of the ETSI Statutes: a) In accordance with article 10.3, members should regularly inform the Director-General of their current ECRT. b) In the case where the Member's ECRT is not able to be determined from publicly available information, the Member will agree with the Director General on the appropriate class of contribution which should apply. c) In the event that a member is not able to declare its ECRT and is not willing to agree with the Director General on the appropriate class of contribution which should apply then it shall be assigned the highest class of contribution. d) SME and Micro-Enterprise members shall, after presenting evidence to the Director-General, contribute 1 unit. e) Universities and Public Research Bodies shall be entitled to pay a reduced first unit of contribution. f) A company, being part of the same corporate group, i.e. companies being AFFILIATES (as defined in Annex 6), with one membership only shall determine its class of contribution from the ECRT based upon the worldwide turnover generated by the entire corporate group’s products and services related to Article 2 "Purpose" and Article 3 "Scope of activities" in the ETSI Statutes. g) Micro-Enterprises shall be entitled to pay a reduced first unit of contribution

Page | 3 – V1.2 (ETSI Statutes) Article 2: Purpose

The objective of the Institute is to produce and perform the maintenance of the technical standards and other deliverables which are required by its members.

As a recognized European Standards organization, an important task shall be to produce and perform the maintenance of the technical standards which are necessary to achieve a large unified European market for telecommunications, ICT, other electronic communications networks and services and related areas.

At the international level, the Institute shall aim to contribute to world-wide standardization in the fields described above. The objective of the Institute may be achieved by any means. The Institute may carry out any action relating directly or indirectly, wholly or in part, to its objective or which may develop or facilitate the achievement of its objective.

(ETSI Statutes) Article 3: Scope of activities

The principal role of the Institute shall be technical pre-standardization and standardization in Information and Communication Technology (ICT) at the European level including in the following fields:

 Telecommunications, ICT, and other electronic communications networks and services  Areas common to telecommunications, ICT, and other electronic communications networks and services, and information technology in co-ordination with CEN and CENELEC  Areas common to telecommunications, ICT, and other electronic communications networks and services, and broadcasting (especially audio-visual and multi-media matters) in co-ordination with CEN, CENELEC and the EBU.

At the global level, the Institute shall contribute to world-wide standardization in the fields described above to produce and perform the maintenance of the technical standards and other deliverables which are required by its members.

In addition, the Institute shall be open to co-operation with other organizations when appropriate.

The activities of the Institute shall contribute to the production and the promotion of new harmonized world-wide standards and furthermore shall build upon world-wide standards, existing or in preparation.

Declaration of ECRT

When considering what ECRT to declare, members should take into consideration the entire turnover related to electronic communications related products, components and services, regardless of technology or standard used. This should of course include turnover related to the entire range of technologies and services standardized by ETSI in the past and/or currently under development, and the previous work of CEPT. Gross turnover or revenue, and not net income, should be considered.

The Rules of Procedure, Annex 2, clause 6f) state that where a Member company is part of a corporate group, the ECRT is based upon the worldwide turnover generated by the entire corporate group's products and services related to electronic communications, not simply that of the Member company.

Where more than one company from a corporate group is an ETSI Member, the sum of ECRTs declared by these companies shall be equal to or greater than the ECRT calculated on the basis of the entire corporate group.

In the case where the member's ECRT is not able to be determined from publicly available information, the member will agree with the Director- General on the appropriate class of contribution which should apply.

In the event that a member is not able to declare its ECRT and is not willing to agree with the Director-General on the appropriate class of contribution which should apply then it shall be assigned the highest class of contribution, i.e. 45 units.

6 Participation in ETSI Partnership Projects

Exceptionally, the General Assembly may decide that the right to participate in a Partnership Project is subject to the payment of a minimum contribution to the ETSI budget.

ETSI member participation in 3GPP™ is subject to a minimum payment of 3 units of contribution excluding SMEs, Micro-Enterprises, Users, universities, and public research bodies which are subject to a minimum payment of 2 units of contribution.

Page | 4 – V1.2 ANNEX B (informative only) BULLETIN D’ADHÉSION À L’ETSI

Nom et adresse de l’administration ou organisation légalement constituée, candidate à l’adhésion. ______TEL ______FAX ______SITE WEB ______Légalement constituée dans un pays de la zone géographique de la CEPT* (Membre titulaire) Légalement constituée dans un pays hors de la zone géographique de la CEPT* (Membre associé) Éligible en tant que membre titulaire ou associé mais ne souhaitant pas participer aux travaux techniques (Membre observateur) * CEPT : Conférence européenne des administrations des postes et des télécommunications Domaine d’activités : ______Représentée par : Prénom, nom de famille, position détenue au sein l’administration ou l’organisation candidate à l’adhésion ______Ayant pris connaissance des Statuts et du Règlement intérieur de l’ETSI disponibles sur http://portal.etsi.org/Directives/home.asp, demande à adhérer à l’ETSI dans la catégorie suivante :

Administration Également habilité à adhérer PME en tant que Autre organisme public (le cas échéant) Micro-entreprise Société de conseil Association professionnelle Fabricant Association d’utilisateurs Exploitant de réseau Association d’utilisateurs sans but lucratif Organisme de recherche (privé) Organisme de recherche (public) Preuves des éléments ci-dessus à fournir Université sous forme de rapports officiels ou Prestataire de services d’attestation. Utilisateur Autre et demande également à participer à 3GPP™ Oui Non Voir Annexe A – 6 (ci-jointe) Renseignements relatifs aux interlocuteurs

Nom et adresse de l’interlocuteur officiel - personne à laquelle toute correspondance doit être adressée. ______TEL ______FAX ______EMAIL ______

Nom et adresse de l’interlocuteur financier – personne à laquelle toutes les correspondances liées à des questions de frais d’adhésion doivent être adressées (si celui-ci est distinct de l’interlocuteur officiel) ______TEL ______FAX ______EMAIL ______

Page | 5 – V1.2 ANNEX B (informative only)

Adresse de facturation des frais d’adhésion (devant figurer sur les Facture à adresser à factures) ______Interlocuteur officiel ______Interlocuteur financier ______Adresse de facturation

N° TVA intracommunautaire ______N° SIRENE (pour organisations Francaises seulement) ______

Renseignements sur les frais d’adhésion Administrations Si une autre Administration de votre pays est déjà membre de l’ETSI et paie des frais d’adhésion en fonction du PIB (Produit Intérieur Brut) de votre pays, veuillez cocher cette case Si votre Administration est responsable de la réglementation sur les communications électroniques et domaines apparentés pour ce pays, veuillez indiquer le PIB de votre pays en EUROS €______Voir Annexe A - 1 & 2 (ci-jointe)

Autres organisations Veuillez indiquer le chiffre d’affaires apparenté aux communications électroniques de votre organisation en EUROS (ne concerne pas les administrations, organismes de recherche publics, universités, associations professionnelles, associations d’utilisateurs et associations d’utilisateurs sans but lucratif)

€______Voir Annexe A - 5 (ci-jointe)

Adhésion complémentaire Si vous souhaitez une Adhésion complémentaire pour une adhésion de groupe existante pour laquelle des frais d’adhésion ont déjà été déterminés – Voir Annexe A - 4 (ci-jointe), veuillez indiquer le NOM DE L’ORGANISATION possédant cette adhésion de groupe. Adhésion de groupe ______

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Par la présente, l’administration ou organisation candidate à l’adhésion accepte de et s’engage à se conformer aux Statuts et au Règlement interne de l’ETSI et à toutes les décisions prises par l’Assemblée Générale de l’ETSI, contribuer aux travaux, appliquer les normes produites dans la mesure du possible et encourager l’utilisation de ces normes comme base des normes et recommandations mondiales. Par la signature de ce bulletin d’adhésion, vous déclarez détenir l’autorité légale requise pour contraindre l’administration ou l’organisation aux représentations et aux engagements stipulés dans le présent bulletin d’adhésion. Lu et approuvé au nom de l’administration ou l’organisation : Nom et qualité de la personne autorisée (en majuscules) ______Lieu ______Date ______

L’adhésion est renouvelée automatiquement tous les ans (voir les Statuts : Rules of Procedure, Article 1, clause 1.4.1 pour plus d’informations).

Cachet officiel Signature

Page | 6 – V1.2